Poisoning Injuries among Alaska Native People in Alaska, 2002-2011

INTRODUCTION: During 1999-2005, poisoning was the third leading cause of unintentional injury death for Alaska Native People (AN) and suicide attempts by intentional poisoning remains a leading cause of injury hospitalizations. Current findings on poisoning for AN and the associated data challenges are reported.

METHODS: Data were obtained from the Alaska State Trauma Registry (ATR), the Alaska Bureau of Vital Statistics, and the Alaska Department of Labor and Workforce Development for 1992-2011. Injury frequencies, age-adjusted rates, and trends were calculated. Significance was tested at the 95 % confidence level using the z test.

RESULTS: From 2002-2011, 276 AN died from unintentional poisoning: 51.4% from medications and drugs, 41.3% from alcohol, and 7.2% from other poisons.  The AN statewide rate for poisoning deaths was 2.4 times higher than non-Natives (27.2 and 11.5 per 100,000, respectively, p<0.05).  Reported rates for AN poisoning deaths were 4.6 times higher in 2008-2011 than they were in 1992-1995, a significant increase (8.6 and 39.6 per 100,000, respectively, p<0.05). Intentional poisoning-related suicide attempts were the second leading cause of AN injury hospitalizations (2,253) statewide.  The rate of AN intentional poisoning-related suicide attempt hospitalizations doubled between 1992-1995 to 2008-2010 (10.4 and 20.7 per 10,000, respectively, p<0.05).

CONCLUSIONS: Poisoning is a leading cause of AN injury morbidity and mortality. Unintentional poisoning mortality rates and intentional suicide-related poisoning hospitalization rates have both increased for Alaska Native people over the past two decades. Recent changes in diagnostic coding and reduced ATR reporting for poisoning have altered data availability and comparability.  Despite data challenges, it was determined that poisoning causes a large proportion of Alaska Native injuries. In order to monitor this issue and evaluate interventions, it will be important to have surveillance systems that provide adequate data.